title: A pilot randomized trial comparing a commercial weight loss program with a clinic-based intervention for weight loss.
abstract: OBJECTIVE
  To compare the efficacy of a popular commercial program with that of a clinic-based intervention for weight loss.
  
  
  METHODS
  Randomized clinical trial conducted at an internal medicine clinic affiliated with a city hospital in Denver, Colorado. Participant (n = 46) had a body mass index ≥ 30 kg/m(2) and no life-threatening medical conditions. They either were provided a voucher to attend Weight Watchers for 17 weeks (n = 23), or they were assigned to the clinic group (n = 23), which provided 12 visits over 17 weeks and the option to augment weight loss using either meal replacements or weight loss medication. The primary study outcome was weight change.
  
  
  RESULTS
  Participants assigned to the clinic arm lost 4.0 ± 1.2 kg, compared to 0.4 ± 1.1 for those assigned to the commercial program (P = .04 for difference). Weight losses in the clinic arm were 3.2 kg for meal replacements (n = 10) and 5.0 kg for phentermine (n = 13).
  
  
  CONCLUSIONS
  In this single-site trial, a clinic-based intervention was more effective than a popular commercial program for weight loss. Primary care providers in the United States are under increasing pressure to combat the epidemic of obesity. This trial, although small, begins to address how the primary care setting might play that role.
authors.affiliation: Denver Health and Hospital Authority, Denver, Colorado, USA.
authors.forename: Adam G
authors.initials: AG
authors.lastname: Tsai
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Raube
authors.forename: Judith
authors.initials: J
authors.lastname: Conrad
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Bessesen
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Rozwadowski
keywords: commercial weight loss programs; meal replacements; obesity; pharmacotherapy; primary care